One of the main reasons Apple changed the phone industry was with their roll out of a multi-touch capacitive touch screen phone, the iPhone 2G.  The multi-touch display on the iPhone and iPad allows users to use pinch to zoom functionality, along with a whole host of other gestures.  Basically, when you see someone “flicking” their iPhone or iPad screen – thank the muti-touch display for enabling this.

Other companies have quickly followed suit with multi-touch displays, and currently there are tens of millions of devices that utilize them.  Over time, the use of these gestures adds up – and yet with millions of multi-touch users, no one knows the musculoskeletal side effects these gestures could potentially produce.  A team of researchers hopes to change this lack of knowledge.

Dr. Kanav Kahol, an assistant professor in ASU’s Department of Biomedical Informatics, is leading a team of researchers from Arizona State and Harvard with the goal of studying potential side effects of multi-touch displays, and how these systems can be designed to cause the least amount of musculoskeletal harm.  They have a $1.2 million grant from the National Science Foundation for their research.

The team will be using cyber gloves (picture), EMG equipment, and other devices to quantify the amount of strain gestures from multi-touch displays produce on the hands and wrists.  In the picture they are studying the iPad, but they plan on studying multiple devices.  Dr. Kahol hopes to show this data to Microsoft, Apple, and other companies so they can modify and refine their multi-touch gestures accordingly.

From the original article:

Kahol said that the last time designers developed a fundamental interaction system with computers they modified the standard keyboard. While it was useful, it was not without its share of drawbacks.

“When we developed the keyboard, we didn’t think through how working with it would affect the hands, arms, etc.,” Kahol said. “As a result, it created a multimillion dollar industry in treating carpal tunnel syndrome. That is what we want to prevent with multi-touch systems.

“We are going for the preventative, rather than the curative,” he added.

Source: http://www.eurekalert.org/pub_releases/2010-06/asu-pfo060710.php

Related Posts:

1. Why Multi-Tasking on the iPhone OS is not good for Healthcare – Especially for future Electronic Health Record Apps
2. How to sync the right user with the right medical app for their iPhone, iPod Touch, and the upcoming iPad
3. iPad could support “Handwriting Keyboard” – A requirement for medical point of care use in health care

Radiation Passport aims to fulfill an important need: to quantify the cancer risk for the various diagnostic imaging studies and to add up the cumulative exposure and cancer risk for one patient. The app makers explicitly invite lay persons to track their own cumulative dose (thus the monicker “passport”) but the design and vocabulary appear to be targeted more toward physicians.

While the diagnostic benefits of modern imaging techniques are easily appreciated, the risk of exposure to ionizing radiation is less well understood. This question has become more acute as recently published studies attempting to quantify cancer risk from diagnostic radiation were widely picked up by media outlets. I can attest that, in recent months, many of my patients have brought up this coverage when I ordered scans. At the same time, I have also decreased orders for CT scans and even x-rays in my pediatric patients.

Radiation Passport (iTunes link) was designed and built by a team of two brothers, one of whom is a radiologist – and is priced at $3.99. The application includes a well written “background” section which deals early-on with the vexing dilemma of calculating cancer risk – that much of of the data on cancer risk is extrapolated from atomic bomb data – by simply stating it is the best information available. Much of the background section of the app is drawn from an accompanying article in the Journal of American College of Radiology, in which the brothers describe the application’s methodology.

What is not controversial is that usage of diagnostic imaging has increased dramatically over the last two decades. For example, in the background section of the app, it quotes an article stating that the number of CT scans performed has doubled every two years since the mid 1980s. Another quoted article (Brenner and Hall, 2007) apparently claims that up to 1.5-2% of ALL cancers in the US may become attributable to radiation from CT scans alone, if current usage rates continue. These numbers make it clear that mitigating this risk is an increasingly important goal for patients and physicians alike.

The application has two main functions. One is a straightforward “calculator” of radiation exposure. Studies are sorted into categories such as “cardiology”, “dental”, “GI”, “CT”, etc. The other is a personal repository of cumulative radiation exposure. The application takes into account the age of the patient and the age at the time of radiation exposure. This is important since radiation induced cancers usually take many years to develop and therefore, exposure at young age is considered higher risk than later in life. The app automatically enters the average amount of radiation exposure for each type of study (in milli-Sieverts), although this default can be overridden.

Once the studies have been entered, the app displays a pie chart of the different modalities’ contribution to cumulative lifetime radiation exposure and cancer risk. It is interesting to see that background earth radiation is actually a large proportion to the cumulative dose, that is until one gets a few CT scans under the belt !

What I liked about this app:

• it addresses an important need for physicians and patients
• it is well referenced and thoughtfully designed
• provides rich functionality, both in the range of parameters that can be entered and the types of studies and also in ways the resulting risk can be displayed

What I thought could be improved

Conclusion

Radiation Passport is a very well thought-out application that addresses an important need. It is well documented and comes at a time of increasing attention to the cancer risk of diagnostic imaging by physicians and patients. In order to achieve its potential the application interface should be streamlined and the confusing use of medical jargon mitigated to allow for better usage by lay persons.

Update
Tidal Pool Software (www.tidalpool.ca), the makers of Radiation Passport, has announced a partnership with Clario Imaging to integrate their dose and risk cumulative logging functions directly into Clario zVision radiology and picture archiving information system (RIS/PACS). This will be helpful for physicians to inform them, at the point of order entry, the cumulative dose and risk for their patients.

Related Posts:

1. Are patients receiving too much radiation with diagnostic imaging?
2. eRoentgen App Helps Physicians Choose Appropriate Imagine Studies [App Review]
3. Health Canada approves iPhone medical app for diagnostic imaging use – FDA to follow suit? [Resolution MD Mobile]

We’re giving away 5 promo codes for one of the most popular PDF readers in the App Store via the comments section of this post.  We’ve reviewed it on this site before and now the app is boasting some significant upgrades.

There were fireworks at the recent Google developer conference (“Google I/O”). Some of this was well deserved excitement around features found in the newest version of the Android mobile operating system (version 2.2, “Froyo”). Much of the fireworks, however, were due to loud, public taunting of the iPhone and Steve Jobs by senior Google executives.

Since everybody loves a contest, these statements by Google speakers were widely covered in the tech press and predictably stirred up heated comment threads throughout the blogosphere.

In truth, the schoolyard level of the rhetoric (see Kara Swisher) probably does not serve Google’s interests in the long run. This is because Google’s business relationships are symbiotic: Google needs its partners’ trust to continue delivering to Google, via their devices and services, massive amounts of user data for its primary business, which is selling advertising.

As a result of the mentioned spectacle, people seem to forget an important fact: that business-wise, Android is competing against Microsoft not Apple. Microsoft is a software vendor, like Google, but it makes billions by licensing its OS cheaply to multiple hardware vendors. Unfortunately, it seems Google has destroyed that marketplace by giving away its OS for free. John Gruber’s recent insightful post on the Google I/O conference provides more insight on this.

Apple, in contrast to Microsoft and Google, is more of a hardware vendor. Its business model depends on producing consistently great products and charging customers a premium for them. Apple makes a lot of money doing this and, as Gruber suggested, does not need more 20-25% of the marketplace to be wildly successful (it currently has 19%). Apple is only interested in the top portion of the market and already has an astonishing 90% of the market share for PCs costing more than $1000. But, if Apple stops making great products, its business model disappears.

Android promise is near-complete freedom for developers & handset makers and rapid iteration. This freedom will necessarily mean that Android will be fragmented, with multiple software and hardware versions (see Engadget) being sold at any given time. Thus, one can predict that handset and software incompatibilities will negatively impact application development, enterprise adoption and user experience. But, these impediments are not going to stop wide-spread adoption of Android since it only has to be “good-enough” to be accepted at low prices in the mass marketplace.

In the long run, as many have said, there will be more Android than iPhone devices – a lot more (see previous post). But, despite the heated rhetoric from Google, Apple will continue to thrive by continuing to deliver a highly polished user experience with a deep bench of applications deployed on a consistent platform. Nor will the iPhone vanquish Android with its permissive ecosystem, free licensing and large market share.

Related Posts:

1. Apple or Google? The Answer is Both – What the Future Holds for their Competing Mobile Platforms
2. Nexus One and the Android Family vs. the iPhone: What’s the Medical Professional To Do?
3. Microsoft Potentially Moving to Major Healthcare Partnership Related to Electronic Medical Records – Apple and Google Beware!

Over the last few months, a great deal of time has been expended on the “hot competition” between Apple and Google in relation to smart phones. Much of this interest probably had to do with a partially imagined story of a once close friendship between Apple and Google, founded on their mutual enmity of Microsoft, now fractured on the rocks of competition and greed. While the truth probably isn’t as dramatic, whatever conflict exists is much less interesting than where they may overlap – especially when imagining where medical technology could go and how it would affect medical professionals. As most readers are undoubtedly aware, much of the recent discussion in the blogosphere on this topic (at least before January 27) was about the rapid ascent of the Android platform. The emergent themes were that the open and mutable nature of the Android operating system, the entry of multiple handset makers, and the absence of any restriction on software publishing will inevitably make Android the dominant smart phone platform of the future. The historical analogy given was desktop computing, where commodity hardware and a minimally restrictive operating system made Microsoft Windows the de facto standard, despite many obvious flaws. But, it seems this analogy is flawed and here’s why.

1. There will be more Android devices in the future than iPhone OS devices. Lots more.

Android is based on the Linux kernel, which already powers an unimaginable range of computers and devices. Google’s contribution of a rich communication and user interface layer will mean that we will not only see Android in phones and tablet computers but also cars, thermostats, refrigerators and who-knows-what else. This is going to be great for consumers. But, it’s not clear that the future ubiquity of Android means it will also be the de facto platform for smart phones. Many commentators have already made the arguments that Android phones will not be a unified platform, but rather splintered by a wide variety of hardware configurations, and that separately building the operating system and the devices will lead to unintended compromises.

What I want to emphasize, however, is that developing software for mobile devices is fundamentally different from developing desktop and enterprise applications. Specifically, mobile applications are much smaller and simpler to build. Most only take a few weeks of programmers’ time. The numerous developers rapidly publishing Android versions of their iPhone apps have already proven this and it means mobile computing is not going to be a winner-takes-all platform race. There are currently five major platforms: Symbian (Nokia), Blackberry (RIM), iPhone OS, Android and Windows Mobile. Maybe not all will survive into the next decade, but it’s difficult to imagine only one remaining.

2. The profitability and competition in the device market will help Apple too

If there was any doubt about this, just look at Apple’s most recent quarterly blow-out earnings. The number to look at is not the revenue of $15.7 billion (more than double Google’s, by the way) but rather the gross margin of 40%. This is incredible. Commodity hardware and open-source software means there will always be competitors entering with lower-priced devices. But do not forget that Apple also benefits from these same downward price pressures. In fact, Apple’s market power gets it lower prices on flash memory than its competitors, while it leverages open-source software development in its operating system kernel and web browser.

As proof of this principle, just look at the iPad’s starting price of $499. By designing its own CPU, Apple has further eliminated another supply cost. By being profitable at this low price, Apple just might have knocked out the legs from the consumer netbook market. Also, while Google can enter the device business, Apple can also enter the advertising business. Apple’s purchase of the mobile advertising company Quattro and its plans to integrate innovative advertisement displays directly into its mobile operating system suggest the latter isn’t far off either.

3. Mobile computing is most powerful when it interfaces to web data, but both ends are important

Tim O’Reilly, one of the most perceptive technology observers, recently reviewed the Google Nexus One and effectively suggested that it is not Apple vs Google but rather Apple vs the web. In an information age, controlling the data (i.e. Google) is more important than controlling the device (i.e. Apple).

Prognosticating in information technology is murky as web-based services are evolving very rapidly. Google will clearly remain a dominant storehouse of data into the foreseeable future. But new companies will continue to arise with compelling data in their sectors, such as Yelp for local restaurant and vendor reviews, IMDb for movies, and Twitter for social networking.  And then of course there are the medical databases such as Cochrane, PubMed, and EMR-based patient data. But, even if cloud-based computing is the “killer app” for mobile computing, its means of consumption is very relevant. In fact, there will always be room to innovate on the user interface -  witness the iPhone. If we use the car analogy and consider cloud data to be roads and highways, who wouldn’t want a nicer car(device – user interface) to drive?

Conclusion

We know history does not quite repeat itself, but does echo. So rather than reciting the story of Microsoft vs Apple with new characters, I suggest that we look beyond that simple analogy and consider it may not be Apple or Google in the mobile world, but rather it will be both. I expect both companies will flourish and we, the consumers, will be the beneficiaries.

Related Posts:

1. Google’s Android OS strategy is following Microsoft’s lead – not Apple’s
2. Mobile platforms wars have primed web apps for a comeback [Guest Post]
3. Nexus One and the Android Family vs. the iPhone: What’s the Medical Professional To Do?

With over 100,000 apps available for the iPhone/iPod Touch and billions of downloads since the App Store opened just under two years ago, the market is clearly hot. And with the release of the iPad, expect a new flood of apps into the market.  However, a recent article in the New York Times suggests that even with the wealth of options, people generally use only five apps despite having downloaded far more.

The average iPhone or iPod Touch owner uses 5 to 10 apps regularly, according to Flurry, a research firm that studies mobile trends. This despite the surfeit of available apps: some 140,000 and counting.

Another finding that the article notes is that even thought hundreds of thousands of apps are available, the entire user group is generally exposed to the same few thousand apps.

A survey of iPhones, iPod Touch and Android users conducted in July 2009 by AdMob, an advertising network that helps people promote their applications on smartphones, found that people discover apps most often by browsing app stores. And even though the iTunes store is bloated with offerings, people tend to gravitate to the most popular….

“…The top apps featured at the store do change out,” Mr. Putney said. “But most users will never see more than 1 percent of the total apps available.”

These findings are important for iPhone/iPod Touch/iPad users, app developers, and even us here at iMedicalApps, and here’s why. For users, this means that finding the best apps requires some work – a conscious effort to search the app store for things that interest you. That includes looking beyond the most popular medical apps. For developers, this means that reaching potential customers requires finding ways to climb that popularity ladder. For the Malcolm Gladwell enthusiasts, this means finding the Mavens, Connectors, and Salesman (from Tipping Point) – basically the people with large social (or professional) networks who are most likely to adopt early and spread the message about your great app. And for us here at iMedicalApps, it means actively looking for that diamond in the rough, languishing at the bottom of the popularity rankings, and helping our readers discover useful apps they wouldn’t have seen otherwise.

Related Posts:

1. Should Medical Professionals Get an iPhone or an iPod Touch?
2. The Best and Most Useful Medical Apps for the iPhone or iPod Touch
3. Side effects of multi-touch screens on the iPhone, iPad, and other devices being studied by Arizona State researchers

The iPad has created a great deal of buzz in the tech community. The medical and healthcare community at large are set to benefit from some of its key features, mentioned in our prior posting.  One of these key features, the beautiful 1024 by 768 pixel, 9.7 inch screen, is set to change the overall user experience for medical apps that have a focus on imaging, such as anatomy applications.  Although this medical app review was done using an iPod Touch, we can only imagine how much more aesthetically pleasing the iPad’s experience will be. As will be discussed later in the post, these applications are a perfect example of how the upcoming iPad could be used in the clinic setting to improve patient education.

A key thing to remember is your iPhone medical apps will run just fine on the iPad.  This post will review a trio of Modality’s latest anatomy flash card apps and provide extensive pictures of the following: Clemente’s Anatomy, Rohen’s Photographic Anatomy, and Moore’s Clinical Anatomy.

Modality now has a variety of Anatomy Flashcard apps to choose from, depending on your preference. In addition to Netter’s Anatomy, an app we reviewed awhile back, Modality’s newest editions are Clemente’s, Moore’s and Rohen’s anatomy.  They are all priced at $24.99 (except for Netter’s, which is still $39.99).

Due to the similarities of these applications they will be reviewed in one post.  I’ve been using Modality’s Netter’s Anatomy Flashcards app for almost a year now and have a good reference to compare these new apps to.

Ultimately, your choice of anatomy app will come down to the anatomy book you like or the anatomy book your school uses.  I originally chose the Netter’s app for this reason.  These apps have generally the same user interface, and mainly differ on the type of anatomy images they provide.  However, individually, they each have some strengths and weaknesses.

Clemente’s

• Strengths: Great for the lymphatic system and also for schematics to simplify diagrams (e.g. brachial plexus, spinal nerve roots, dermatomes, etc.); Some X-ray images included; Excellent for bones and muscles.




• Weaknesses: Lacks “back of card” information that explains the anatomy in the illustration.

More Clemente’s Sample Pictures:

Moore’s

• Strengths: Excellent Cranial Nerves section and Head/Neck detail; great “back of card” information including effect of lesions to the area; Great illustrations for viscera and organs.




• Weaknesses: No X-ray images; Generally uses more ‘dull’ or pastel colors, consequently less aesthetically pleasing.

More Moore’s Sample Pictures:

Rohen’s

• Strengths: Fantastic color photos right from cadavers; Great brain/cranium/face specimens; Includes X-ray, Angiogram, CT and MRI images; Zooming in provides amazing level of detail; Would be very helpful for Anatomy Lab Practical.




• Weaknesses: Sometimes with real cadaver photographs it’s difficult to find what you’re looking for since everything is pretty much “flesh colored”; lacks “back of card” information.

More Rohen’s Sample Pictures:

What I liked about these applications:

It’s nice Modality offers you four different choices of anatomy apps for the iPhone that use the same user interface.  This makes switching between apps easy and it allows users to pick what works best for them. Here’s a quick list of the features that go beyond what you’d expect from the typical navigation in each individual “card”:

• The best feature is the ability to “Add Structure” to a card. That means you can include a new custom pin to label anatomy your own way, or you could use this pin to include a short mnemonic to help with memorization.
• For each structure there are links to Google and Wikipedia, allowing a quick way to search more info
• When using the zoom feature, image quality remains the same, and screen resolution is preserved.  Again, this feature should work fantastically on the iPad.
• Simple yet effective quiz mode on each card that asks you to find the structure in question.
• There is a decent search function on the main screen of the apps allowing you to directly find anatomic structures of the body.

What I didn’t like about these applications:

• You are not given the ability to add your own extensive notes to a whole card, or even to a given structure.
• Once you’re viewing a particular card/image you can no longer see the title of the card.  If you’ve forgotten what you’re looking at, you can’t easily check it again.  Instead, you have to click back to the menu to see the title and then click back into the card again.

What I would like to see in future updates:

• Ability to add custom notes on each separate card
• Ability to view the card title from within the card
• Landscape mode
• More advanced quiz features (overall quiz for all cards, random selection, % correct)

These anatomy apps would be good for the following:

Students will benefit the most from these Anatomy Flashcard apps. This includes medical students, but really all health professionals who need to learn anatomy (physician assistants, nurse practitioners, etc). The apps are also useful health care providers in general who need a quick anatomy refresher every once in a while or a good anatomy reference in your pocket.

Patient education, especially on the iPad

Another key function of these app would be for patient education.  Orthopedic surgeons or even family medicine doctors could show their patients the exactly anatomy of their pathologies.  These anatomy applications will also work on the soon to be released iPad, and showing patients these images on a beautiful display could improve their understand and also make their office visit more exciting.  These types of interaction could improve the overall patient physician relationship.

Conclusion:

The Modality Anatomy Flashcard apps are well designed and work well too. They are a good replacement for paper-based flashcards by the respective authors. The plus is that they are more mobile than paper-based cards; the minus is that you can’t share them with others easily (or sell them used when you’re done!).

Ultimately you really just need to pick the one app you like most and stick with it – use the brief descriptions at the beginning of this review to help you out, or take a look at the hard cover books/flashcard equivalents online or in a bookstore before you make the plunge and purchase one of the apps on iTunes. I personally might just hold on to two of them: Netter’s because I’m partial to his illustrations, and Rohen’s because I like the cadaver images used. But really I probably like these two most because they are the ones we used at my school.

Links:

Clemente’s Anatomy Flash Cards: Modality, iTunes, Publisher Website

Rohen’s Photographic Anatomy Flash Cards: Modality, iTunes, Publisher Website

Moore’s Clinical Anatomy Flash Cards: Modality, iTunes, Publisher Website

Iltifat Husain contributed to the writing of this post

Related Posts:

1. Human Body 3D Anatomy App Might be Useful for Patient Education, But Not Much Else [App Review]
2. Netter’s Musculoskeletal Flash Cards App Brings Back Classic Netter Drawings [App Review]
3. Gray’s Anatomy brought to the iPhone, Not the Show [App Review]

As the debut of the iPad fast approaches, speculation about it is reaching a fevered pitch. Scanning the thousands of articles written about the iPad’s potential, one may walk away thinking that Steve Jobs has just cured cancer, ended global warming, and established peace in the Middle East. Some people are even calling Apple’s latest creation the “Jesus tablet.” While the iPad probably falls somewhere short of some of those lofty projections, it has already done what Apple seems to do best – transformed the way we look at an existing market, in this case mobile computing and the tablet. We’ve talked previously about how the iPhone paved the way for the iPad in healthcare. Again, Apple’s entry into this market has signaled a huge shift in the way users will interact with the tablet and, through it, their environment.  This new user interface has a great deal of potential to change the way physicians deliver care. But perhaps more importantly, it could also have profound impacts on the way patients experience healthcare.

Innovative therapies

Over the past decade, there have been a number of examples of novel technologies being used either therapeutically for sick patients or in preventative care. For example, there have been numerous trials, with more success in the pediatric population, that use text messaging to remind patients to take their medications. When the iPhone transformed the user interface for the smartphone, therapies centered on that platform also emerged – autism and major depression are two conditions with iPhone apps that are therapeutic in nature. Enter the iPad. With a more advanced touchscreen, a high-quality webcam, and perhaps even 3d graphics, the possibilities become far more rich.

Take children with cancer – these kids can be hospitalized for weeks at a time and, due to the chemotherapy, stuck largely in isolation for most of that time. An app that utilizes the webcam to connect kids while playing a fun and interactive game together would provide a far richer interaction than a networked gaming console. Or consider the numerous elderly patients who succumb to delirium while in the hospital largely because, on top of being sick, life in the hospital, void of sunlight and normal sleep-wake patterns, gets so disorienting. Consider an app that, much like the mentally challenging games on the Nintendo DS, helps older patients stay a little more active during the day and perhaps ward of delirium. Will the iPad cure cancer or, for that matter, anything? No. But what it will do is provide some interesting and creative adjuncts to standard therapy that could make the patient’s quality of life a little better.

Improved patient-provider communication

In the ever growing iPhone app store, educational apps are among the most numerous. One of the biggest reasons why is because the interface allows user to interact with the material in a number of different ways. Take the Blausen Human Atlas or Pocket Heart – both of these apps allow the user to interact with anatomy in an incredibly rich way. With much more powerful graphics capabilities, these kinds of apps can certainly be taken to another level.

Consider a patient going into surgery. Today, explanation of the surgery is restricted to some form of charades by the surgeon and 2d radiology images. An app that allows 3d reconstructions of a patient’s scans to be pulled onto the iPad and manipulated would allow for a far better explanation, improving patient-physician communication. Or how about the diabetic patients or the heart failure patients? These poor folks are often subjected to hours of mind-numbing “educational” videos in the hospital – iPad apps could bring an element of interactivity that allows patients to engage with material that is critical to their health. Finally, consider the stroke patient. There are rumors that the iPad’s camera will be sufficiently sensitive to allow facial recognition. Perhaps then it could also be used to detect facial, or for that matter limb and trunk, motion with apps designed for post-stroke rehabilitation therapy. In a “game” format, individual goals outside of professional physical therapy could help empower the patient as they fight to recover.

The key opportunity that the iPad offers here is not just another platform to convey information, but a way to make it fun and engaging. While the iPad won’t replace a good physician taking the time to talk to a patient, it could certainly augment the patient-provider relationship in a fun and engaging way.

These are just a few ways that the iPad could transform the way a patient understands their illness and interacts with their healthcare providers. Among the most elusive goals in medicine is helping patients understand complex diseases and empower them to manage these conditions. Nothing will ever replace a strong patient-provider relationship, a personal support network, and evidence-based therapies based on a thorough scientific foundation. But the iPad could herald the introduction of innovative adjuncts that help patients take control of their own health and improve their quality of life.

Related Posts:

1. Five Lessons Apple must learn from current Healthcare Tablets if the Apple Tablet (iPad) is to Succeed in the Medical Industry
2. Apple iPad: Promising Features For Healthcare Use and Medical Education
3. How the iPhone has paved the way for a quicker transition by the Healthcare industry to an Apple OS Tablet

The momentum and enthusiasm in the mobile technology world is, these days, clearly with Google.  The question for many people is whether to go with the reigning champion of the mobile device world(arguably Apple) or to take a chance on the challenger. The Nexus One, the flagship of the Android family of mobile devices, was unveiled to much fanfare in advance of the Consumer Electronics Show (CES) in Las Vegas. The veritable King Midas of the online world had finally decided to take on its equally successful counterpart in the consumer electronics world. In the middle of this battle of the corporate titans, what’s the medical professional to do?

Previous commentary has often focused on the first few Android-based phones in comparison to the iPhone, such as our previous post addressing Verizon’s Droid vs. iPhone. But the choice is much broader – as integration of local and web-based resources improves, you’re really making a choice between a parallel suite of services. As Nick Bilton of the New York Times points out, the Nexus One is highly integrated with Google’s suite of online tools. So if you use Google Reader to keep up with the New England Journal, have your institutional emails centralized in your Gmail account, or otherwise live in the “Google world” then the Nexus One and Android-family of phones may have some clear functionality advantages.

Another advantage that Google brings is an army of software and hardware developers via the Open Handset Alliance who support the Android operating system, which is a Linux-based open source system. As such, Google does not charge mobile device manufacturers for Android, which Saul Hansell of the New York Times suggests may be because Google’s real ambition here is to prevent anyone, whether Apple or Microsoft, from controlling the mobile OS market. Some forecasts are suggesting that Android will control a larger percentage of the market than Apple by as early as 2012, with a forecast by Gartner Inc. estimating a 14.5% to 13.7% advantage. The plus here for medical professionals could be an operating system that evolves more rapidly and stimulates a even richer suite of applications produced by third party developers. We’ve already looked at some of these possible medical apps, such as dictation services for the Nexus One.

However, this same potential strength also exposes a potential weakness, namely fragmentation of the Android market leading to incompatibility across different handsets running the “same” Android operating system. Differences in phone features, screen sizes, and other characteristics could create some pains for developers, especially as new players like Lenovo and Dell join the traditional handset manufactures and create even more diversity in the Android market. In our commentary on whether the Droid will motivate developers, one developer commented that there is a substantial opportunity cost involved with learning a new platform. While a large Android community may raise the incentive to enter this market, fragmentation would essentially mean that developers will be weighing many small markets against the large cost of learning the relevant platforms.

Another recently exposed weakness is customer support. Google has traditionally relied on online forums, FAQ sites, and other similarly low-cost support mechanisms for its online suite of applications. With the release of the Nexus One, Google has started to learn a hard lesson that Apple has done pretty well with – keeping customers happy when things go wrong. Right now, early-adopters of the Nexus One have to call Google for software problems, HTC for hardware problems, and T-Mobile for service problems. As you can imagine, there are a fair number of people who are pretty unhappy with this. And if mobile technology is going to continue to expand among medical professionals, then reliability and robust support are a must.

All in all, the Nexus One and the Android family are well positioned and widely predicted to become a big time player in the mobile market. The iPhone has clearly transformed the mobile technology market and developers like Modality have used this platform to develop innovative and valuable tools for medical professionals. But many of the advantages the iPhone boasted when it first appeared, especially the rich developer community, are now being replicated and expanded upon by the Android family. And if Google is really not looking to turn the Android Operating System into a major revenue source, then it could be an even more dangerous challenger for the iPhone.

Originally Posted on MedPage Today ; Iltifat Husain contributed to this post.

Related Posts:

1. Epocrates app now available for Android Smartphone – Medical professionals with Droid and Nexus One rejoice
2. Should medical professionals get an iPhone, Blackberry, or Android phone? It’s complicated.
3. Epocrates Rx for Android gets reviewed – Our first Android medical app review

So you’re a practicing provider or you’re in medical school.  You’ve seen some interesting medical applications out there and you’re wondering if you should get an iPhone or an iPod Touch.  This is a scenario that is often e-mailed to our site from providers and students.  In order to answer this question, I’ll first talk about the differences between the two devices and how the user experience will vary from a medical standpoint.

The iPod Touch runs the same operating system as the iPhone, called the iPhone Operating System.  However, the iPod touch has key hardware limitations that differentiate it from the iPhone.

The major difference between the two is obvious.  The iPod Touch doesn’t have any cellular capabilities.  So in order to use the internet, you must be connected to WiFi (wireless internet).  This is key to note because there are certain applications that require you to have an internet connection.  Two that come to mind are the Blausen Human Atlas and the Clinical Orthopedic Exam Apps.  These apps can function without a dedicated internet connection, but you aren’t able to use them to their full potential.  Both apps require you to stream videos that are not built into the applications.

If you hospital has a dedicated WiFi connection and your iPod Touch can connect to this WiFi connection easily, then this difference will not affect you.  But if your hospital does not have a dedicated WiFi connection, or if it’s difficult for you to connect to the internet, than the iPhone would be a better option if you want to use applications such as these to their maximum potential.  Remember though, if you aren’t getting reception in the hospital, often the case with AT&T, than your iPhone won’t be able to connect to the internet unless you turn the WiFi on. 

My suggestion would be to contact your hospital’s IT department to see if they can connect your iPhone or iPod Touch to the wireless internet.  In order to use the WiFi in my hospital you have to go through a login screen, which can be extremely painful and annoying.  Luckily, the IT department is great and they were able to change the wireless setting on my iPhone so I didn’t have to go through the normal login screen anymore and and now my iPhone is always connected to WiFi. 

To be honest, for medical professionals, this is the main key difference between the two devices.  The medical apps we’ve run across don’t really utilize the added functionality of the iPhone, such as Push-notification, GPS, and the camera.  Medical Apps such as Epocrates, Merck Manual Professional, and other reference apps don’t require this added functionality and will run just fine on your iPod Touch. 

If you’re always in the hospital, and are easily able to connect to WiFi, then I’d recommend you stick to the iPod Touch and save yourself from having to pay the extra monthly data fee that comes with the iPhone.  Plus, if you’re a resident you’re working 24/7 anyways and you probably won’t even that that much of a chance to use the extra functionality. 

If you’re a medical student, all the study applications we’ve reviewed, such as the USMLE question banks and anatomy apps, will work just fine on an iPod Touch. 

There are also some minor differences, such as the lack of an extra “zoom” feature that the iPhone has.  I highlighted this in the iRadiology review.  This feature can be useful when looking at detailed radiology, however, it’s not that big of a deal.

Now if you want to get the iPhone because you want a dedicated smart phone, than by all means, it’s a great device.  I went with the iPhone because I need to always be connected to the internet so I can respond to e-mails.  I use the push-button notification,push-email, and GPS functionality constantly, but I’m fully aware that many healthcare professionals don’t. 

In our reviews, if a medical app has limitations on the iPod Touch, we almost always comment on it.  If you still aren’t sure though, feel free to comment on this post or a particular review before you buy a medical app and your question will get answered.

Related Posts:

1. How to sync the right user with the right medical app for their iPhone, iPod Touch, and the upcoming iPad
2. The Best and Most Useful Medical Apps for the iPhone or iPod Touch
3. Optimizing Your Medical Practice Experience with the iPod Touch